Basic Information
| Provider Information | |||||||||
| NPI: | 1902910458 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEN | ||||||||
| FirstName: | GRACE | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5214 SANGAMORE RD | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208162322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156586791 | ||||||||
| FaxNumber: | 4155200904 | ||||||||
| Practice Location | |||||||||
| Address1: | 5214 SANGAMORE RD | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208162322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156586791 | ||||||||
| FaxNumber: | 4155200904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 05/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 0101251716 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | PAR | 01 | VA | CIGNA | OTHER | 1902910458 | 01 | VA | COVENTRY HEALTH NETWORK | OTHER | 1902910458 | 05 | VA | MEDICAID | 1902910458 | 01 | VA | VIRGINIA PREMIER HEALTH PLAN | OTHER | PAR | 01 | VA | USA MANAGED CARE | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | -032 | 01 | VA | TRICARE/CHAMPUS | OTHER | 1902910458 | 01 | VA | UNITED HEALTHCARE | OTHER | PAR | 01 | VA | AETNA | OTHER | 10093667 | 01 | VA | OPTIMA HEALTH | OTHER | 472496 | 01 | VA | ANTHEM BC/BS | OTHER | 5920233 | 05 | NC | MEDICAID | PAR | 01 | VA | CORVEL | OTHER | PAR | 01 | VA | VIRGINIA HEALTH NETWORK | OTHER |